[1]《人工智能在甲状腺相关性眼病中的应用指南（0）》专家组,中国医药教育协会眼科影像与智能医疗分会,中国医师协会眼科分会眼肿瘤专委会,等.人工智能在甲状腺相关性眼病中的应用指南(2023)[J].眼科新进展,2023,43(11):841-847.[doi:10.13389/j.cnki.rao.2023.0169]
　Expert Workgroup of Guidelines for the Application of Artificial Intelligence in Thyroid Associated Ophthalmopathy(0),Ophthalmic Imaging and Intelligent Medicine Branch of Chinese Medicine Education Association,Ocular Oncology Committee of the Ophthalmology Branch of the Chinese Medical Doctor Association,et al.Guidelines for the application of artificial intelligence in thyroid-associated ophthalmopathy (2023)[J].Recent Advances in Ophthalmology,2023,43(11):841-847.[doi:10.13389/j.cnki.rao.2023.0169]
点击复制

人工智能在甲状腺相关性眼病中的应用指南(2023)/HTML
分享到：

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
43卷
期数:
2023年11期
页码:
841-847
栏目:
述评
出版日期:
2023-11-05

文章信息/Info

Title:
Guidelines for the application of artificial intelligence in thyroid-associated ophthalmopathy (2023)
作者:
《人工智能在甲状腺相关性眼病中的应用指南（2023）》专家组; 中国医药教育协会眼科影像与智能医疗分会; 中国医师协会眼科分会眼肿瘤专委会; 国际转化医学会眼科专业委员会; 中国眼科影像研究专家组
Author(s):
Expert Workgroup of Guidelines for the Application of Artificial Intelligence in Thyroid Associated Ophthalmopathy(2023); Ophthalmic Imaging and Intelligent Medicine Branch of Chinese Medicine Education Association; Ocular Oncology Committee of the Ophthalmology Branch of the Chinese Medical Doctor Association;  Ophthalmology Committee of International Association of Translational Medicine;  Chinese Ophthalmic Imaging Study Groups
关键词:
甲状腺相关眼病; 人工智能; 深度学习; 自动诊断
Keywords:
thyroid-associated ophthalmopathy;  artificial intelligence;  deep learning;  automatic diagnosis
分类号:
R771.3
DOI:
10.13389/j.cnki.rao.2023.0169
文献标志码:
A
摘要:
甲状腺相关性眼病（TAO）是一种与甲状腺功能障碍相关的复杂眼眶病，严重危害患者视功能、损害患者容貌外观和降低患者生活质量。TAO的诊断和管理复杂，近几年，基于人工智能（AI）算法的医疗应用已经被开发，这些应用已被证明在筛查许多慢性眼病方面是有效的。自动化AI设备的先进特性，如快速性、便携性和多平台兼容性，使得临床上对这些疾病的早期诊断和详细评估取得了重大进展。本文就AI在TAO临床诊断、活动度评价和严重程度分级以及治疗结果预测等方面的应用形成共识，为AI在TAO中的进一步研究和应用提供参考。
Abstract:
Thyroid-associated ophthalmopathy (TAO) is a complex orbital disease associated with thyroid dysfunction, severely damaging patients’ visual function, facial appearance and quality of life. TAO diagnosis and management are highly complex. In recent years, medical applications based on artificial intelligence (AI) algorithms have been developed, and these applications have been proven effective in screening many chronic eye diseases. Based on the advanced features of automated AI devices, such as rapidity, portability, and multi-platform compatibility, significant progress has been made in the early diagnosis and detailed evaluation of these diseases in clinical practice. This article forms a consensus on the application of AI in clinical diagnosis, activity and severity grading, and outcome prediction of TAO, providing references for further research and application of AI in TAO.

参考文献/References:

［1］　BARTLEY G B,FATOURECHI V,KADRMAS E F,JACOBSEN S J,ILSTRUP D M,GARRITY J A,et al.The incidence of Graves’ ophthalmopathy in Olmsted County,Minnesota［J］.Am J Ophthalmol,1995,120(4):511-517.
［2］　WIERSINGA W M,BARTALENA L.Epidemiology and prevention of Graves’ ophthalmopathy［J］.Thyroid,2002,12(10):855-860.
［3］　邵毅,陈偲翊,廖许琳.2019甲状腺相关性眼病管理实用指南解读［J］.国际眼科杂志,2021,21(8):1408-1411.
SHAO Y,CHEN C Y,LIAO X L.Interpretation of management guidelines for Graves Ophthalmopathy in 2019［J］.Int Eye Sci,2021,21(8):1408-1411.
［4］　RUNDLE F F.Management of exophthalmos and related ocular changes in Graves’ disease［J］.Metabolism,1957,6(1):36-48.
［5］　BARTALENA L,KAHALY G J,BALDESCHI L,DAYAN C M,ECKSTEIN A,MARCOCCI C,et al.The 2021 European Group on Graves’ orbitopathy (EUGOGO) clinical practice guidelines for the medical management of Graves’ orbitopathy［J］.Eur J Endocrinol,2021,185(4):G43-G67.
［6］　《人工智能在干眼临床诊断中的应用专家共识（２０２３）》专家组，中国医药教育协会眼科影像与智能医疗分会，中国人口文化促进会角膜病与眼表疾病分会.人工智能在干眼临床诊断中的应用专家共识(2023)［J］.眼科新进展,2023,43(4):253-259.
Expert Consensus on Clinical Application of Artificial Intelligence in Dry Eyes Expert Group,Ophthalmic Imaging and Intelligent Medicine Branch of China Medical Education Association,Corneal and Ocular Surface Diseases Branch of Chinese Population and Society Promotion Association.Expert consensus on clinical application of artificial intelligence in dry eyes(2023)［J］.Rec Adv Ophthalmol,2023,43(4):253-259.
［7］　中国医药教育协会数字影像与智能医疗专委会,中国医药教育协会智能医学专委会.全球眼科图像公开数据库使用指南(2022)［J］.眼科新进展,2022,42(12):925-932.
Digital Imaging and Intelligent Medical Branch of China Medical Education Association,Intelligent Medical Special Committee of China Medical Education Association.Guidelines for the use of global public databases on ophthalmic images(2022)［J］.Rec Adv Ophthalmol,2022,42(12):925-932.
［8］　杨卫华,邵毅,许言午.眼科人工智能临床研究评价指南(2023)［J］.国际眼科杂志,2023,23(7):1064-1071.
YANG W H,SHAO Y,XU Y W.Guidelines on clinical research evaluation of artificial intelligence in ophthalmology(2023)［J］.Int Eye Sci,2023,23(7):1064-1071.
［9］　PENG Y,DHARSSI S,CHEN Q,KEENAN T D,AGRN E,WONG W T,et al.DeepSeeNet:a deep learning model for automated classification of patient-based age-related macular degeneration severity from color fundus photographs［J］.Ophthalmology,2019,126(4):565-575.
［10］　SMITH T J,HEGEDS L.Graves’ disease［J］.N Engl J Med，2016,375(16):1552-1565.
［11］　MOURITS M P,KOORNNEEF L,WIERSINGA W M,PRUMMEL M F,BERGHOUT A,VAN DER GAAG R.Clinical criteria for the assessment of disease activity in Graves’ ophthalmopathy:a novel approach［J］.Br J Ophthalmol,1989,73(8):639-644.
［12］　KAUPPINEN-MKELIN R,KARMA A,LEINONEN E,LYTT-YNIEMI E,SALONEN O,SANE T,et al.High dose intravenous methylprednisolone pulse therapy versus oral prednisone for thyroid-associated ophthalmopathy［J］.Acta Ophthalmol Scand,2002,80(3):316-321.
［13］　GRUS F H,AUGUSTIN A J,TOTH-SAGI K.Diagnostic classification of autoantibody repertoires in endocrine ophthalmopathy using an artificial neural network［J］.Ocul Immunol Inflamm,1998,6(1):43-50.
［14］　SALVI M,DAZZI D,PELLISTRI I,NERI F.Prediction of the progression of thyroid-associated ophthalmopathy at first ophthalmologic examination:use of a neural network［J］.Thyroid,2002,12(3):233-236.
［15］　SALVI M,DAZZI D,PELLISTRI I,NERI F,WALL J R.Classification and prediction of the progression of thyroid-associated ophthalmopathy by an artificial neural network［J］.Ophthalmology,2002,109(9):1703-1708.
［16］　HUANG X,JU L,LI J,HE L,TONG F,LIU S,et al.An intelligent diagnostic system for thyroid-associated ophthalmopathy based on facial images［J］.Front Med,2022,9:920716.
［17］　KARLIN J,GAI L,LAPIERRE N,DANESH K,FARAJZADEH J,PALILEO B,et al.Ensemble neural network model for detecting thyroid eye disease using external photographs［J］.Br J Ophthalmol,2022，2022:321833.
［18］　DOLMAN P J.Evaluating Graves’ orbitopathy［J］.Best Pract Res Clin Endocrinol Metab,2012,26(3):229-248.
［19］　HOSTEN N,SANDER B,CORDES M,SCHUBERT C J,SCHRNER W,FELIX R.Graves ophthalmopathy:MR imaging of the orbits［J］.Radiology,1989,172(3):759-762.
［20］　CUBUK M O,KONUK O,UNAL M.Orbital decompression surgery for the treatment of Graves’ ophthalmopathy:comparison of different techniques and long-term results［J］.Int J Ophthalmol,2018:11(8):1363-1370.
［21］　HIGASHIYAMA T,IWASA M,OHJI M.Quantitative analysis of inflammation in orbital fat of thyroid-associated ophthalmopathy using MRI signal intensity［J］.Sci Rep,2017,7(1):16874.
［22］　LIN C,SONG X,LI L,LI Y,JIANG M,SUN R,et al.Detection of active and inactive phases of thyroid-associated ophthalmopathy using deep convolutional neural network［J］.BMC Ophthalmol,2021,21(1):39.
［23］　SONG X,LIU Z,LI L,GAO Z,FAN X,ZHAI G,et al.Artificial intelligence CT screening model for thyroid-associated ophthalmopathy and tests under clinical conditions［J］.Int J CARS,2021,16(2):323-330.
［24］　HANAI,TABUCHI H,NAGASATO D,TANABE M,MASUMOTO H,MIYA S,et al.Automated detection of enlarged extraocular muscle in Graves’ ophthalmopathy with computed tomography and deep neural network［J］.Sci Rep,2022,12(1):16036.
［25］　LEE J,SEO W,PARK J,LIM W S,OH J Y,MOON N J,et al.Neural network-based method for diagnosis and severity assessment of Graves’ orbitopathy using orbital computed tomography［J］.Sci Rep,2022,12(1):12071.
［26］　SAEED P,TAVAKOLI RAD S,BISSCHOP P.Dysthyroid optic neuropathy［J］.Ophthalmic PlastReconstr Surg,2018,34(4S Suppl 1):S60-S67.
［27］　VICTORES A J,TAKASHIMA M.Thyroid eye disease［J］.Int Ophthalmol Clin,2016,56(1):69-79.
［28］　WU C,LI S,LIU X,JIANG F,SHI B.DMs-MAFM+EfficientNet:a hybrid model for predicting dysthyroid optic neuropathy［J］.Med Biol Eng Comput,2022,60(11):3217-3230.
［29］　VANNUCCHI G,COVELLI D,CAMPI I,ORIGO D,CURR N,CIRELLO V,et al.The therapeutic outcome to intravenous steroid therapy for active Graves’ orbitopathy is influenced by the time of response but not polymorphisms of the glucocorticoid receptor［J］.Eur J Endocrinol,2014,170(1):55-61.
［30］　HU H,CHEN L,ZHANG J L,CHEN W，CHEN H H，LIU H，et al.T2-weighted MR imaging-derived radiomics for pretreatment determination of therapeutic response to glucocorticoid in patients with thyroid-associated ophthalmopathy:comparison with semiquantitative evaluation［J］.J Magn Reson Imaging,2022,56(3):862-872.
［31］　WANG Y,WANG H,LI L,LI Y,SUN J,SONG X,et al.Novel observational study protocol to develop a prediction model that identifies patients with Graves’ ophthalmopathy insensitive to intravenous glucocorticoids pulse therapy［J］.BMJ Open,2021,11(12):e053173.
［32］　MARCOCCI C,ALTEA M A,LEO M.Treatment options for Graves’ orbitopathy［J］.Expert Opin Pharmacother,2012,13(6):795-806.
［33］　OEVERHAUS M,WITTELER T,LAX H,ESSER J,FHRER D,ECKSTEIN A.Combination therapy of intravenous steroids and orbital irradiation is more effective than intravenous steroids alone in patients with Graves’ orbitopathy［J］.Horm Metab Res,2017,49(10):739-747.
［34］　PRUMMEL M F,TERWEE C B,GERDING M N,BALDESCHI L,MOURITS M P,BLANK L,et al.A randomized controlled trial of orbital radiotherapy versus sham irradiation in patients with mild Graves’ ophthalmopathy［J］.J Clin Endocrinol Metab,2004,89(1):15-20.
［35］　TANDA M L,BARTALENA L.Efficacy and safety of orbital radiotherapy for Graves’ orbitopathy［J］.J Clin Endocrinol Metab,2012,97(11):3857-3865.
［36］　MARCOCCI C,BARTALENA L,ROCCHI R,MARIN M,MENCONI F,MORABITO E,et al.Long-term safety of orbital radiotherapy for Graves’ ophthalmopathy［J］.J Clin Endocrinol Metab,2003,88(8):3561-3566.
［37］　JIANG J,LUO Y,WANG F,FU Y,YU H,HE Y.Evaluation on auto-segmentation of the clinical target volume (CTV) for Graves’ ophthalmopathy (GO) with a fully convolutional network (FCN) on CT images［J］.Curr Med Imag,2021,17(3):404-409.
［38］　JIANG J,ZHOU L,HE Y,JIANG X,FU Y.Using stacked neural network to improve the auto-segmentation accuracy of Graves’ ophthalmopathy target volumes for radiotherapy［J］.J Biomedical Eng,2020,37(4):670-675.
［39］　EZZELL G A,GALVIN J M,LOW D,PALTA J R,ROSEN I,SHARPE M B,et al.Guidance document on delivery,treatment planning,and clinical implementation of IMRT:report of the IMRT Subcommittee of the AAPM Radiation Therapy Committee［J］.Med Phys,2003,30(8):2089-2115.
［40］　ZHANG X,DAI G,ZHONG R,ZHOU L,XIAO Q,WANG X,et al.Radiomics analysis of EPID measurements for patient positioning error detection in thyroid associated ophthalmopathy radiotherapy［J］.Phys Med,2021,90:1-5.
［41］　LIU W,ZHANG L,DAI G Y,ZHANG X B,LI G J,YI Z.Deep neural network with structural similarity difference and orientation-based loss for position error classification in the radiotherapy of Graves’ ophthalmopathy patients［J］.IEEE J Biomed Health Inform,2022,26(6):2606-2614.
［42］　RONCEVIC R,JACKSON I T.Surgical treatment of thyrotoxic exophthalmos［J］.Plast Reconstr Surg,1989,84(5):754-760.
［43］　LIMONE P P,MELLANO M,RUO REDDA M G,MACERA A,FERRERO V,SELLARI FRANCESCHINI S,et al.Graves’ orbitopathy:a multidisciplinary approach［J］.Q J Nucl Med Mol Imaging,2021,65(2):157-171.
［44］　YOO T K,CHOI J Y,KIM H K.A generative adversarial network approach to predicting postoperative appearance after orbital decompression surgery for thyroid eye disease［J］.Comput Biol Med,2020,118:103628.
［45］　CLOVER A J P,FITZPATRICK E,HEALY C.Analysis of methods of providing anonymity in facial photographs:a randomised controlled study［J］.Ir Med J,2010,103(8):243-245.
［46］　YANG Y,LYU J F,WANG R X,WEN Q,ZHAO L Q,CHEN W B,et al.A digital mask to safeguard patient privacy［J］.Nat Med,2022,28(9):1883-1892.
［47］　NEAG E J,SMITH T J.2021 update on thyroid-associated ophthalmopathy［J］.J Endocrinol Invest,2022,45(2):235-259.
［48］　LOPOMO A,BERRIH-AKNIN S.Autoimmune thyroiditis and myasthenia gravis［J］.Front Endocrinol,2017,8:169.
［49］　BRANDT F,GREEN A,HEGEDUS L,BRIX T H.A critical review and meta-analysis of the association between overt hyperthyroidism and mortality［J］.Eur J Endocrinol,2012,166(5):958.
［50］　BANO A,CHAKER L,MATTACE-RASO F U S,VAN DER LUGT A,IKRAM M A,FRANCO O H,et al.Thyroid function and the risk of atherosclerotic cardiovascular morbidity and mortality:the Rotterdam study［J］.Circ Res,2017,121(12):1392-1400.
［51］　FANG S,LU Y,HUANG Y,ZHOU H,FAN X.Mechanisms that underly T cell immunity in Graves’ orbitopathy［J］.Front Endocrinol,2021,12:648732.
［52］　ZHAO J,LIU X,XU J,FANG Y,DU P,GAO C,et al.Elevated expression and activation of GPR15 in immune cells in Graves’ disease［J］.Biomolecules,2022,12(12):1899.
［53］　LI Q,WANG B,MU K,ZHANG J A.The pathogenesis of thyroid autoimmune diseases:new T lymphocytes-Cytokines circuits beyond the Th1-Th2 paradigm［J］.J Cell Physiol,2019,234(3):2204-2216.
［54］　WU D,XIAN W,HONG S,LIU B,XIAO H,LI Y.Graves’ disease and rheumatoid arthritis:a bidirectional mendelian randomization study［J］.Front Endocrinol,2021,12:702482.
［55］　VERSINI M.Thyroid autoimmunity and antiphospholipid syndrome:not such a trivial association［J］.Front Endocrinol,2017,8:175.

相似文献/References:

[1]杨文娟 班胜刚 何剑峰.甲状腺相关眼病患者外周血单个核细胞中微小 RNA-146a的异常表达及意义[J].眼科新进展,2012,32(5):000.
[2]王方 朱豫 栗夏莲 明亮.甲状腺相关眼病患者血清中白细胞介素-15和白细胞介素-21的含量及临床意义[J].眼科新进展,2013,33(6):000.
[3]刘芳 朱豫 韩宝红.血清 sICAM-1及透明质酸与糖皮质激素治疗TAO敏感性关系的研究[J].眼科新进展,2012,32(2):000.
[4]刘振华 朱豫.甲状腺相关眼病患者血清可溶性细胞间黏附分子-1和可溶性血管细胞黏附分子-1的检测及临床意义[J].眼科新进展,2013,33(4):000.
[5]唐建,罗清礼. 瘦素基因在甲状腺相关眼病眶脂肪及体外分化眶脂肪细胞中的表达[J].眼科新进展,2014,34(9):801.[doi:10.13389/j.cnki.rao.2014.0222]
[6]金珂,朱豫. 甲状腺相关眼病患者干眼症患病率及特征分析[J].眼科新进展,2015,35(5):473.[doi:10.13389/j.cnki.rao.2015.0129]
　JIN Ke,ZHU Yu. Analysis of prevalence and characteristic of dry eye in patients with thyroid associated ophthalmopathy[J].Recent Advances in Ophthalmology,2015,35(11):473.[doi:10.13389/j.cnki.rao.2015.0129]
[7]欧阳明,刘桂琴,樊宁,等.小蘖碱对甲状腺相关眼病眼眶前脂肪细胞分化的影响[J].眼科新进展,2016,36(1):012.[doi:10.13389/j.cnki.rao.2016.0004]
　OU-YANG Ming,LIU Gui-Qin,FAN Ning,et al.Effects of berberine on differerntiation of orbital preadipocytes of TAO patients in vitro[J].Recent Advances in Ophthalmology,2016,36(11):012.[doi:10.13389/j.cnki.rao.2016.0004]
[8]何小寒,刘桂琴,蒋丽琼,等.甲状腺相关眼病患者和正常人眼眶脂肪组织中脂肪特异性磷脂酶A2的表达[J].眼科新进展,2016,36(9):841.[doi:10.13389/j.cnki.rao.2016.0225]
　HE Xiao-Han,LIU Gui-Qin,JIANG Li-Qiong,et al.Expression of AdPLA in orbital adipose tissue of normal and patients with thyroid associated ophthalmopathy[J].Recent Advances in Ophthalmology,2016,36(11):841.[doi:10.13389/j.cnki.rao.2016.0225]
[9]刘桂琴,欧阳明,王云,等.AdPLA 基因在Ⅲ级静止期甲状腺相关眼病眼眶脂肪内高表达研究[J].眼科新进展,2017,37(4):354.[doi:10.13389/j.cnki.rao.2017.0090]
　LIU Gui-Qin,OU-YANG Ming,WANG Yun,et al.Higher expression of AdPLA in orbital adipose tissue of patients with thyroid associated ophthalmopathy of Ⅲ level and stationary phase[J].Recent Advances in Ophthalmology,2017,37(11):354.[doi:10.13389/j.cnki.rao.2017.0090]
[10]赵金凤,吴桢泉,郑磊,等.人工智能在眼科疾病诊疗的应用现状[J].眼科新进展,2019,39(5):495.[doi:10.13389/j.cnki.rao.2019.0114]
　ZHAO Jin-Feng,WU Zhen-Quan,ZHENG Lei,et al.Application of artificial intelligence in the diagnosis and treatment of ocular diseases[J].Recent Advances in Ophthalmology,2019,39(11):495.[doi:10.13389/j.cnki.rao.2019.0114]

备注/Memo

备注/Memo:
国家自然科学基金（编号：82160195，81800804）；江西省双千计划科技创新高端领军人才项目（编号：jxsq2023201036）；江西省重大（重点）研发专项计划（编号：20223BBH80014，20181BBG70004，20203BBG73059）；江西省杰出青年基金（编号：20192BCBL23020）
注：本指南的国际实践指南注册号为 PREPARE-2023CN484（http://www.guidelines-redistry.cn/）。
更新日期/Last Update: 2023-11-05